The Trump administration on Monday signaled the Affordable Care Act's cost-sharing reduction (CSR) payments to insurers would continue — for now.
But health care industry officials are concerned prolonged uncertainty over the fate of the payments would cause the ACA marketplace to further destabilize and possibly collapse.
According to Politico, the administration plans to ask the U.S. Court of Appeals for the District of Columbia for another 90-day delay in the lawsuit, House v. Price, filed in 2015 by the House of Representatives claiming the CSR payments were illegal. The ACA's cost-sharing program reimburses health insurers to help low-income people make co-payments at the doctor or hospital.
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According to the motion, legislators and the administration are still working on ways to avoid a legal ruling on the case, Business Insider writes. The Trump administration sought a first delay in late February.
"The parties continue to discuss measures that would obviate the need for judicial determination of this appeal, including potential legislative action," the motion read.
Last week, President Donald Trump reportedly told aides he wants to end CSR payments in a ploy to force Democrats to negotiate replacement legislation, sources told Politico.
While advisors to Trump believe ending the subsidies could backfire on the president politically, Trump reportedly told aides in a meeting last Tuesday he wants to end the payments to insurers because he doesn't gain anything by continuing them, a senior White House adviser told Politico.
"Why the hell would we?" Trump reportedly said, adding Congress should find a way to pay for them if lawmakers want them.
In a letter to the top Republican and Democrat leaders in the Senate, eight health care industry groups and the U.S. Chamber of Commerce urged lawmakers to take action now to guarantee a steady stream of CSR funding through 2018.
"Such action would represent a strong, positive step for all consumers who buy their own insurance by eliminating the single most destabilizing factor causing double-digit premium increases for 2018," the groups wrote.
Insurers have just a few weeks to decide whether to participate in individual state marketplaces, and the deadline to file products and initial rates has already passed in some states, according to the letter. Some insurers "are responding to the market uncertainty" by filing premium requests as much as 60 percent higher than their last year's rates.
"Congress must take action now to fund CSR payments," the groups wrote. "At this point, only Congressional action can help consumers."
Likewise, Molina Healthcare sent a letter Washington state insurance regulators this month warning about the consequences of halting of CSR payments, according to the Los Angeles Times.
"If the federal government's full CSR funding commitments are in jeopardy, we believe that the viability of the exchange market is in immediate jeopardy of failing," wrote Peter Adler, who oversees Molina's plans in Washington.
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Katie Kuehner-Hebert
Katie Kuehner-Hebert is a freelance writer based in Running Springs, Calif. She has more than three decades of journalism experience, with particular expertise in employee benefits and other human resource topics.
